Assessment of arterial and cardiopulmonary baroreflex gains from simultaneous recordings of spontaneous cardiovascular and respiratory variability

Lucini, Daniela; Porta, Alberto; Milani, Olivia; Baselli, Giuseppe; Pagani, Massimo

doi:10.1097/00004872-200018030-00007

Cited by 49 publications

(37 citation statements)

References 16 publications

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“…The contribution of the low-pressure cardiopulmonary receptors, which are an important factor contributing to the cardiovascular responses during tilt, was also not included in the overall BRS estimate [32]. A recent paper [33] has addressed this using a trivariate model of baroreceptor gain of HR, BP and "non-arterial" factors. In young, fit subjects during standing the "non-arterial" component of the BRS gain demonstrated the greatest fall whereas the cardiac component did not change significantly.…”

Section: Discussionmentioning

confidence: 99%

Continuous cardiac baroreceptor measurement during tilt in healthy elderly subjects

Youde

Panerai

Gillies

et al. 2002

Clinical Autonomic Research

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Section: Discussionmentioning

confidence: 99%

Continuous cardiac baroreceptor measurement during tilt in healthy elderly subjects

Youde

Panerai

Gillies

et al. 2002

Clinical Autonomic Research

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“…The BRS and the gain of the feedforward mechanical pathway were estimated by the methodology reported by Porta and colleagues (1,9,18). Briefly, after identification of the coefficients of the M-variate autoregressive model with M ϭ 3 in ⍀ ϭ {HP, SAP, RESP}, the baroreflex feedback arm, from SAP to HP, was described by the regression of HP on past SAP values, whereas the regression of SAP on past HP values described the mechanical feedforward arm, from HP to SAP.…”

Section: Methodsmentioning

confidence: 99%

“…The modelbased closed-loop estimate of the BRS was obtained by observing the response of the relation from SAP to HP induced by an artificial increase of SAP with unit slope (1,9,18). The corresponding slope of the HP increase was taken as an estimate of the BRS and indicated as ␣ CL (1,9,18).…”

Section: Methodsmentioning

confidence: 99%

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Cardiovascular control in women with fibromyalgia syndrome: do causal methods provide nonredundant information compared with more traditional approaches?

Zamunér

Porta

Andrade

et al. 2015

American Journal of Physiology-Regulatory, Integrative and Comp

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-The cardiovascular autonomic control and the baroreflex sensitivity (BRS) have been widely studied in fibromyalgia syndrome (FMS) patients through the computation of linear indices of spontaneous heart period (HP) and systolic arterial pressure (SAP) variabilities. However, there are many methodological difficulties regarding the quantification of BRS by the traditional indices especially in relation to the issue of causality. This difficulty has been directly tackled via a model-based approach describing the closed-loop HP-SAP interactions and the exogenous influences of respiration. Therefore, we aimed to assess whether the BRS assessed by the model-based causal closed-loop approach during supine and active standing in patients with FMS could provide complementary information to those obtained by traditional indices based on time and frequency domains. The findings of this study revealed that, at difference with the traditional methods to quantify BRS, the causality analysis applied to the HP, SAP, and respiratory series, through the model-based closed-loop approach, detected lower BRS in supine position, as well as a blunted response to the orthostatic stimulus in patients with FMS compared with healthy control subjects. Also, the strength of the causal relation from SAP to HP (i.e., along the cardiac baroreflex) increased during the active standing only in the control subjects. The model-based closed-loop approach proved to provide important complementary information about the cardiovascular autonomic control in patients with FMS. fibromyalgia; baroreflex; autonomic nervous system; modeling; causality FIBROMYALGIA SYNDROME (FMS) is a noninflammatory syndrome characterized by chronic diffuse musculoskeletal pain, stiffness, and pain hypersensitivity in 18 specific points located in muscles or tendon muscle insertion called tender points (27). Although the painful condition is the main characteristic of this syndrome, advancements regarding the etiology and pathophysiology of FMS have attributed an important role to dysautonomia (i.e., the autonomic nervous system dysfunction) (4,7,11,12,24,25).The dysautonomia has been widely demonstrated in patients with FMS. Thus, it is known that FMS patients present an alteration of the cardiac autonomic modulation characterized by a high cardiac sympathetic modulation and low cardiac parasympathetic modulation even at rest (4,7,11,12,24,25). In addition, despite a normal baroreflex function, a lack of increased sympathetic discharge to vessels and decreased cardiac vagal activity has been reported during the orthostatic stimulus, which may account for the reduced orthostatic tolerance, commonly observed in these patients (7).Traditionally, the baroreflex sensitivity (BRS) in FMS patients has been studied through the computation of indices derived from spontaneous heart period (HP) and systolic arterial pressure (SAP) variabilities (4,7,11,12,24,25). However, these approaches to the quantification of BRS have many methodological drawbacks. The most relevant one is the in...

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“…One other advantage is that this approach allows us to obtain a comprehensive assessment of the primary mechanisms that contribute to HRV and BPV, using data measured from a single test procedure lasting between 5 and 10 min. Similar approaches, with individual differences in model structure, have been employed by previous workers to investigate the control of heart rate and blood pressure (Baselli et al 1998;Mukkamala et al 1999;Lucini et al 2000); however, none have been used to study autonomic control in SDB.…”

Section: Minimal Closed-loop Model Of Autonomic Cardiovascular Controlmentioning

confidence: 99%

Modeling of Autonomic Control in Sleep-Disordered Breathing

Khoo

2007

Cardiovasc Eng

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There is ample evidence to support the notion that chronic exposure to repetitive episodes of interrupted breathing during sleep can lead to systemic hypertension, heart failure, myocardial infarction and stroke. Recent studies have suggested that abnormal autonomic control may be the common factor linking sleep-disordered breathing (SDB) to these cardiovascular diseases. We have developed a closed-loop minimal model that enables the delineation of the major physiological mechanisms responsible for changes in autonomic system function in SDB, and also forms the basis for a noninvasive technique that enables the early detection of cardiovascular control abnormalities. The model is "minimal" in the sense that all its parameters can be estimated through analysis of the data measured noninvasively from a single experimental procedure. Parameter estimation is enhanced by broadening the frequency content of the subject's ventilatory pattern, either through voluntary control of breathing or involuntary control using ventilator assistance. Although the original form of the model is linear and time-invariant, extensions of the model include the incorporation of nonlinear dynamics in the autonomic control of heart rate, and allowing the transfer functions of the model components to assume time-varying characteristics. The various versions of the model have been applied to different populations of subjects with SDB under different conditions (e.g. supine wakefulness, orthostatic stress, sleep). Our cumulative findings suggest that the minimal model approach provides a more sensitive means of detecting abnormalities in autonomic cardiovascular control in SDB, compared to univariate analysis of heart rate variability or blood pressure variability.

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Assessment of arterial and cardiopulmonary baroreflex gains from simultaneous recordings of spontaneous cardiovascular and respiratory variability

Abstract: A trivariate autoregressive model, that considers explicitly the influence of respiration, can subdivide overall, lumped, arterial pressure-heart period baroreflex gain, into two separate components, alphaart and alphacp. Only the latter is reduced by active orthostatism.

Cited by 49 publications

References 16 publications

Continuous cardiac baroreceptor measurement during tilt in healthy elderly subjects

Continuous cardiac baroreceptor measurement during tilt in healthy elderly subjects

Cardiovascular control in women with fibromyalgia syndrome: do causal methods provide nonredundant information compared with more traditional approaches?

Modeling of Autonomic Control in Sleep-Disordered Breathing

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